SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2017
Open to Public
Inspection
Name of the organization
Children's Medical Center of Dallas
 
Employer identification number

75-0800628
Return Reference Explanation
Form 990, Part III, Line 2 New program services Children's Medical Center of Dallas, as the sole member of OCH Holdings doing business as Our Children's House, took over the operations of all outpatient therapy sites that were previous operated by OCH Holdings. This change was effective November 30, 2017 and was done to streamline and consolidate the outpatient therapy services of Children's Health System of Texas in support of its mission to make life better for children.
Form 990, Part V, Line 2a CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST) EIN 75-2062019 IS THE COMMON PAYING AGENT FOR CHILDREN'S MEDICAL CENTER OF DALLAS (CMCD) THEREFORE, ALL APPLICABLE IRS TAX COMPLIANCE FILINGS ARE REPORTED BY CHST ON BEHALF OF CMCD. CMCD HAS APPROXIMATELY 5,300 EMPLOYEES.
Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL CHILDREN'S HEALTH SYSTEM OF TEXAS (EIN 75-2062019) IS THE SOLE MEMBER AND COMMON PAYING AGENT FOR CHILDREN'S MEDICAL CENTER OF DALLAS (CMCD). THEREFORE, Executives, OTHER OFFICERS, AND KEY EMPLOYEES ARE EMPLOYED AND COMPENSATED BY CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). Salary setting is conducted by the related party, CHST and is described at Schedule J, Part I, Line 3. For this reason, questions 15a and 15b are answered no since the filing organization (CMCD) does not perform the salary setting.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons Jeremy Ford and Robert Peterson - Business relationship
Form 990, Part VI, Line 4 Significant changes to organizational documents Bylaws Amendment in 2017 (12/7/17) Section 3.03 Number, Tenure, Election, and Vacancies - Deleted provision that the chair of the Board of the Member and the President and Chief Executive Officer of the Member shall serve as a voting ex officio of the CMCD Board.
Form 990, Part VI, Line 6 Classes of members or stockholders Children's Health System of Texas ("CHST"), a Texas non-profit corporation, is the sole member of the corporation.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body CHST elects all voting members of the organization's Board of Directors.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Member reserve powers are specified in the the organization's bylaws and represent those actions which require member approval. These powers generally encompass changes in the mission of the organization, addition of new members, certain dispositions of assets, amendments to the organization's Certificate of Formation and Bylaws, and appointment of directors.
Form 990, Part VI, Line 11b Review of form 990 by governing body Children's Medical Center of Dallas has delegated its oversight and review of the Form 990 to the Board of Directors of Children's Health System of Texas (CHST), its Sole Member. A draft of the Form 990 is presented to the CHST Audit Committee for review prior to filing. A copy of the Final Form 990 is made available to the CHST directors through our Board portal before it is filed.
Form 990, Part VI, Line 12c Conflict of interest policy Officers, directors, and key employees received a copy of the Statement of Interest form to execute. Disclosures made are reviewed by the CHST Legal Department and the Chief Compliance Officer and discussed as necessary at the appropriate Committee and Board meeting to determine if further action is needed.
Form 990, Part VI, Line 19 Required documents available to the public Certificate of Formation, Consolidated Financial Statements , and the conflict of interest policy is made available upon request.
Form 990, Part X, Line 11 In 2017, CHST management made the decision to combine all investments into one investment pool to gain greater efficiencies and savings on investment fees. Due to this decision Children's Medical Center of Dallas transferred $542 million to the Foundation which was recorded as a net asset transfer.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances Transfer of Investment Pool to Children's Medical Center Foundation - -XXX-XX-XXXX; Pension Liability - -1329499; NetAssets-CMCF-Unrestricted&Temp Restricted - XXX-XX-XXXX; NetAssets-CMCF-Endowment - 20750606; Loss on Extinguishment of Debt - -23302778; Restricted Gifts - 4294097;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2017


Additional Data


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